The first signs and dangerous symptoms of meningitis in children, treatment tactics and preventive measures. Specialists on the signs of meningitis in children. What can you do

Most meningitis is infectious and can be caused by various viruses or bacteria. Meningococcal infection is the most common form of all inflammatory infections of the meninges. This form of infection is recorded in 70-80% of cases in patients with this disease.

Meningitis in the bacterial form is serious and can turn into purulent forms. In most cases, streptococcal and meningococcal forms of meningitis are detected in infants and infants; these infections often lead to serious complications and are difficult.

Serous meningitis is overwhelmingly caused by viruses. These are mainly pathogens that cause rubella and chicken pox. Weakened babies are very susceptible to influenza infection. Problems in the work of the immune system are often fixed, immunodeficiency is observed. Children who have diabetes mellitus or who have been using glucocorticosteroids since birth may develop candidal meningitis.

This disease develops rapidly in a weak child's body. The harmful fungus Candida, which is the cause of candidal meningitis, enters the meninges along with the blood, after which it begins to multiply there, causing severe inflammation. This type of meningitis takes much longer to heal than bacterial meningitis.

The most rare type of meningococcal infection in newborns is the tuberculous variant, which is caused by protozoan microorganisms. This form of the disease occurs only in 2-3% of cases.

When a birth injury occurs, a traumatic form may occur, which is characterized by a severe form of leakage. Patients with this form of meningitis should be advised by a neurosurgeon and regularly monitored by a neurologist.

Examination methods

Extraction of cerebrospinal fluid (CSF) using a special needle for examination. Liquor constantly circulates in the ventricles of the brain. Taken into account:

general blood analysis;
c-reactive protein level;
blood glucose;
electrolytes;
the process of blood clotting;
the presence of bacteria.

The examination is based on the results of methods associated with the isolation of a culture of microorganisms from cultures of cerebrospinal fluid and blood. They may be positive in over 80% of patients who have not received antibiotic therapy. This type of therapy promotes negative cultures due to accumulation of pus in the brain, which can be caused by a specific bacteria, the herpes enterovirus.

Due to an infectious disease, which is meningitis in a newborn, there is an increase in protein in the cerebrospinal fluid and a decrease in glucose concentration. The increase in leukocytes is associated with the presence of white cells involved in maintaining human immunity over 90% in some cases.

To make a diagnosis of meningitis, it is necessary that leukocytes in the cellular composition of the cerebrospinal fluid exceed 21 cells per 1 mm3. Microscopic study of cells obtained from the focus of pathology and the diagnosis of diseases that lead to metabolic disorders may not give the proper result.

The concentration of glucose in the cerebrospinal fluid in a child who was born prematurely is from 55 to 105%, compared with the blood glucose level in a child born at the due date from 44 to 128%. The presence of protein is less than 0.3 g/l or more than 10 g/l.

positive blood culture;
the presence of a bacterial disease, which is manifested by foci of purulent inflammation, which is confirmed by data from clinical and laboratory studies;
the condition noticeably worsens when antimicrobials are used in therapy.

The procedure for inserting a needle into the space of the spinal cord in order to diagnose the composition of the cerebrospinal fluid at the level of the lumbar may be delayed until the patient's condition returns to normal, despite the delay in an accurate diagnosis, as well as the likelihood of incorrect medication.

If a newborn child who is suspected of having meningitis or sepsis has inadequate cerebrospinal fluid parameters, with a negative blood culture and CSF, it is worth re-diagnosing.

To exclude various infections and check for the presence of herpes, toxoplasmosis. With a late analysis of more than two hours, a significant decrease in the number of leukocytes and glucose saturation in the cerebrospinal fluid can be observed. It is best if the tests are with a specialist after half an hour.

Meningitis with CSF values within the normal range is observed in 30% of newborns. Even if the diagnosis is confirmed by microbiological examination, it is not always the cause of changes in the composition of the cells of the cerebrospinal fluid.

Indicators can be on the verge of normal and abnormal. In this case, it is necessary to conduct a survey of newborn patients for the presence of infections that could be transmitted directly from the mother. This applies to herpes, HIV, rubella, syphilis.

Microscopic examination of a native smear. Bacteria can be present in the cerebrospinal fluid in 83% of newborns, which is caused by group B streptococcus. At the same time, in 78% of patients in this group, meningitis appears due to gram-negative microorganisms.

The chance of detecting bacteria in this test is related to their presence in the cerebrospinal fluid. Important in making a diagnosis is the identification of a culture from the CSF, which does not depend on the data obtained from additional procedures.

The virus isolated from the blood is not always associated with a culture of cerebrospinal fluid, and therefore a detailed diagnosis of CSF is necessary. Extraction of cerebrospinal fluid using a special needle that constantly circulates in the ventricles of the brain is necessary if meningitis has not been detected during clinical and microbiological studies.

Treatment

The quality of getting rid of the disease directly depends on the cause of its occurrence, namely: on the pathogen. Purulent type meningitis occurs from a bacterial, fungal or viral infection. In the treatment, methods are used that are aimed at eliminating the pathogen.

This disease is quite dangerous with possible bad consequences, which is why a hospital stay is required. It is extremely important in case of meningitis in a premature baby, treat it only in the hospital, since the baby's body is very weak.

Treatment courses consist of injections of antibiotics, antiviral or antifungal medicines. Medicines are administered in significant volumes until the complete disappearance of the symptoms of the disease. To confirm complete recovery, a re-examination of the CSF is required.

Negative consequences of the disease

Including with timely diagnosis of the disease, the consequences are often negative. If the baby is premature, this only exacerbates the possibility of complications.

Meningitis in babies can lead to the following conditions:

brain abscess.
Lagging behind the age norms of development.
Dementia.
Hearing loss.
Loss of vision.
Dropsy of the brain.
epileptic seizures.
development of paralysis.
Damage to the nervous system.

In 30% of cases of the development of the disease in premature babies, therapeutic measures do not have the proper effect on the body and the situation ends in death.

In children under the age of 1 year, there is a risk of viral meningitis as a complication after ARVI, influenza, and various diseases. In weakened, often ill children, the development of a serous type of the disease is possible. Fungal meningitis caused by candidiasis is also common.

Dangerous symptoms that you should pay attention to and immediately visit a doctor:

intoxication of the body;
diarrhea;
nausea and vomiting;
increase in body temperature;
unexplained crying of a child.

Often, you can begin to suspect an inflammatory process in the meninges when the baby screams in bright light and loud sound. Thus gives the manifestation of soreness in the head during meningitis. In this condition, the lack of urgent medical attention can only aggravate the situation, for example, convulsive seizures.

In such a case, treatment is carried out in a hospital with the help of drugs that destroy the causative agent of the disease.

In children older than 2 years, the causes of meningitis can be:

viral microorganisms of other diseases such as rubella, chickenpox;
microbes;
fungal infections;
bacteria.

Often occurs after contact with stray animals that are carriers of viruses, or with a sick person. Most meningococcal infections occur due to the entry of harmful microorganisms into the human body. Often these are harmful bacteria or viral pathogens.

The undisputed leader among the causes that cause inflammation in the meninges is. This type of meningitis occurs in the vast majority of cases, while the bacterial forms of meningitis are acute and can turn into purulent forms.

Often, newly born babies and infants are susceptible to infection with streptococcal or meningococcal infection. Data diseases are difficult to cure and have a high risk of complications. Serous meningitis is always caused by the ingestion of viruses.

The causative agent of the disease can be the rubella virus, smallpox, etc. The influenza form is often observed in children with poor health. Often these children are found to have abnormalities in the functioning of the immune system. People who have been diagnosed with diabetes can get sick with candidal meningitis, which, along with the flow of blood, can enter the meninges, where it causes severe inflammation.

Such a disease is treated much longer than. Rarely, doctors detect a tuberculosis form. This type occurs in 2-3% of the total number of patients with this type of infection. Traumatic form can occur with birth trauma.

The disease begins to progress in the first days or months after birth. In most cases, the traumatic form causes various complications. During treatment, it is necessary to undergo regular examinations by a neurologist and a neurosurgeon.

Meningitis in newborns is manifested as a result of the ingress of pathogenic microflora into the membranes of the brain. This disease, in the absence of early diagnosis and complex treatment, can provoke the development of a mass of side effects on the body of a newborn, including death. The risk group includes children who have autoimmune diseases, as well as pathologically weakened immunity.

Meningitis is an infectious and inflammatory disease that is provoked by pathogenic microorganisms of a bacterial, viral and fungal nature. The disease is preceded by a weakened immune system, which does not allow timely fight against pathogenic microorganisms, which contributes to a rapid increase in their numbers. Together with the blood flow, they are carried to all tissues and organs, penetrating into the meninges.

The disease develops at lightning speed, in most cases causing a fatal outcome. The pathogenesis of meningitis is due to birth trauma, sepsis and the presence of pathogenic microflora in the mother's blood, which enters the body of the newborn during childbirth.

A feature of the disease in the neonatal period is:

Impossibility of early diagnosis.
Lightning flow.
The presence of complications in the gastrointestinal tract.
Severe dehydration, depressing the work of the kidneys.

Mortality occurs in 50% of cases, so the health of the newborn should be carefully monitored, avoiding contact with sick patients. Against the background of unformed immunity, the risks of infection remain high up to 1 year of life.

Causes

The inflammatory process of the meninges develops due to the ingress of pathogenic microorganisms into the children's body: streptococci, staphylococci, meningococci, E. coli. With the blood flow, these bacteria spread throughout the body, forming inflammatory foci in the brain and spinal cord.

The body of a newborn does not have its own immunity, so any bacteria, even conditionally pathogenic ones, can cause great harm. Most often, infection occurs during delivery or surgery, which is performed in the first weeks of life.

At-risk groups

Statistics show that the incidence of meningitis among newborns is due to factors such as:

The male sex - the body of girls is stronger.
Birth injuries - provoke a violation of normal blood flow, as well as the entry of pathogenic microflora into the body.
The presence of intrauterine pathologies - diseases of the kidneys and gastrointestinal tract, developing at the stage of fetal formation, do not allow the formation of immunity.
Immunodeficiency states in which immunity is completely absent.
The need for a long time to use glucocorticosteroids and other hormonal drugs.
The development of sepsis, which requires long-term antibiotic treatment.

Most often, meningitis is diagnosed in premature newborns. Children born before 35 weeks, in the presence of an infectious-bacterial lesion, die in almost 90% of cases.

Symptoms of the manifestation of pathology

Symptoms of meningitis in newborns are similar to those of a respiratory disease:

The body temperature rises to 39-40 °. The child becomes lethargic and lethargic. Sleeping most of the day.
Heavy and rare breathing, articulated with the appearance of yellowness of the skin.
No urination for 4-5 hours, indicating severe dehydration.
Refusal of food and the appearance of vomiting after eating it.
Spasms of the limbs, which are aggravated by the active crying of the child.

These symptoms should alert parents, as they are harbingers of a dangerous condition.

If they are ignored, the focus of the brain lesion increases, which provokes the development of symptoms specific to meningitis:

Stiffness of the muscles of the back of the head - when laying on the tummy, the child tries to throw his head back and roll over on his side.
Accumulation of cerebrospinal fluid - the fontanel begins to pathologically bulge and pulsate, and in its area the skin becomes hot.
The impossibility of stabilizing body temperature - no antipyretic drugs are able to normalize the temperature.
Soreness of the head and neck muscles - any touch, stroking the skin causes acute pain, which is accompanied by crying and irritability.
Tearfulness during motion sickness - the child begins to cry hysterically when he is motion sick, which is explained by an increase in intracranial pressure and increased headaches.
Spasms of the whole body, which cause paralysis of certain parts of the body, indicate damage to the nerve fibers and require immediate hospitalization.
Coma - the child does not respond to any mechanical stimuli. His breathing and pulse are irregular. Requires immediate resuscitation, the absence of which causes a fatal outcome.

The diagnosis is made on the basis of the results of the examination of the child and the evaluation of the complaints of the parents. The final stage involves the following research methods:

Analysis of the cerebrospinal fluid - a puncture helps to determine the quantitative and qualitative composition of the cerebrospinal fluid, which contains pathogenic microorganisms. By identifying the pathogen, you can choose the most optimal treatment.
MRI and CT - show foci of meningitis (there may be several), the degree of damage to the meninges, as well as the general condition of the baby's body.
Angiography - is prescribed for suspected development of large lesions with the involvement of blood vessels and nerve endings.

Drug therapy involves the use of antibiotics that can neutralize the activity of the causative agent of meningitis. It:

Ceftriaxone;
Cefazolin;
Amoxicillin;
Cefotaxime;
Cefix.

The choice of drug depends on which pathogen caused the inflammatory process. The child's body is supported with vitamins, hepatoprotectors, means to reduce irritation of the gastrointestinal tract.

Detoxification involves the introduction of lytic solutions that replenish the volume of freely circulating blood, as well as the appointment of diuretics that help remove fluid from the body. In the event that the kidneys are affected, hemodialysis may be prescribed. This procedure facilitates the work of the paired organ, enhancing the cleansing functions. It helps to eliminate toxins and toxins, normalizing the metabolic processes of the body.

In the presence of damage to the central and peripheral nervous system, antipsychotics and nootropics are prescribed. They strengthen and restore connections between neurons, which helps restore sensitivity. Seizures are stopped by anticonvulsants and muscle relaxants.

The advanced form of meningitis requires a surgical operation, as a result of which all foci of the inflammatory process are sanitized. After the procedure, the child's condition is rapidly improving, and the risk of developing negative consequences is reduced.

The duration of treatment directly depends on the degree of damage to the meninges, as well as the speed of diagnostic measures.

It is strictly forbidden to treat meningitis at home. The wrong medicine can be ineffective and life-threatening for the newborn. Only a doctor is able to correctly diagnose and choose the best treatment plan.

Complications

Unfortunately, in most cases, the child's body is not able to avoid the development of complications, which include:

epilepsy and other mental problems;
paralysis of various parts of the body;
hydrocephalus;
impaired vision;
deafness;
mental retardation.

In the absence of adequate treatment, disability develops in the shortest possible time. The child will not be able to become a full-fledged member of society and needs additional support.

Prevention

It is completely impossible to prevent the development of the disease. The body of a newborn is unpredictable. Only monitoring the condition and behavior of the child, as well as timely consultation with the doctor will help to avoid undesirable consequences.

You can reduce the risk of infection in an infant by following these rules:

limit the baby's contact with strangers;
avoid contact with sick family members;
in the presence of a respiratory disease, treat the child in a hospital under the close supervision of doctors;
properly dress the child, avoiding hypothermia and overheating;
Minimize visits to public places for up to 1 year.

A child under one year old should visit a pediatrician every month, who is required to perform a complete examination. If there are deviations, you need to consult with more highly specialized specialists.

Forecast

In 50% of all cases of detection of meningitis in newborns, a fatal outcome develops. The process of development of swelling of the brain occurs very quickly, so all vital functions are rapidly fading away.

With a favorable outcome, there is a high risk of complications, as well as negative consequences. 2-3 years after recovery, the child is periodically examined by an infectious disease specialist and a pediatrician, since the risks of re-infection remain.

Modern medicine is able to eliminate or stop most of the existing pathological processes. For this, countless drugs, physiotherapeutic procedures, etc. have been created. However, many therapies are most effective in the early stages of the disease. Meningeal syndrome can be distinguished among such pathological processes. It is a complex of manifestations characteristic of irritation of the meninges. Among its causes are meningitis, meningismus and pseudomeningeal syndrome. The latter type is completely a consequence of mental disorders, pathologies of the spine, etc. Inflammation of the meninges is characteristic only of the first 2 types, therefore it is recommended to find out what meningeal symptoms exist in order to identify the problem in time and begin treatment.

Meningeal syndrome, regardless of the cause of occurrence, is expressed by certain symptoms. The first signs of the disease are as follows:

Sensation of aches all over the body, as with a cold;
General lethargy and fatigue even after sleep;
Increased heart rate;
Failures in the respiratory system;
Temperature increase over 39º.

Gradually, meningeal symptoms (signs) appear more and more intensely and new ones are added to the previous signs:

Manifestation of seizures. This symptom occurs mainly in children. For adults, its appearance is considered rare;
Adoption of a meningeal posture;
Development of abnormal reflexes;
The occurrence of a headache. This symptom is the main one and is manifested extremely intensely. The pain intensifies mainly due to external stimuli, for example, light, vibration, sound, sudden movements, etc. The nature of the pain is usually acute and they can be given to other parts of the body (neck, arms, back);
The occurrence of vomiting due to severe headache;
Development of hypersensitivity (hyperesthesia) to light, vibration, touch, sounds, etc.
Rigidity (petrification) of the muscular tissue of the neck.

The combination of these symptoms is a meningeal syndrome. The degree of manifestation and the combination of symptoms may be different, since there are many reasons for this pathological process. The presence of pathology is determined mainly with the help of instrumental examination (lumbar puncture, MRI, etc.), but initially attention should be paid to its main manifestations.

Main features

During the examination, the doctor focuses on the following signs:

Bechterew's symptom. It is determined by light tapping on the cheekbones. At the same time, the patient begins an attack of headache and facial expressions change;
Brudzinski's symptom. It is divided into 3 types:
- Upper form. If the patient is placed on a couch and asked to stretch his head to his chest, then along with this movement, the legs involuntarily bend at the knee joint;
- Cheek shape. This symptom is actually similar to Bekhterev's symptom;
- Pubic shape. If you press on the pubic region, then the patient reflexively bends the lower limbs at the knee joint.
Fanconi sign. A person is not able to sit down on his own if he is in a supine position (with knees extended or fixed);
Knik's symptom. To check for this sign, the doctor presses lightly around the corner of the lower jaw. With meningeal syndrome, due to this action, acute pain occurs;
Gillen's sign. The doctor checks for such a sign of meningeal syndrome by squeezing the quadriceps muscle on the front of the thigh. At the same time, the same muscle tissue on the other leg is reduced in the patient.

Among other symptoms characteristic of inflammation of the meninges, 2 main manifestations of the pathological process described by Klunekamph can be distinguished.

The essence of the first symptom is that when the patient tries to stretch his knee to his stomach, pain occurs that radiates to the sacral region. A feature of the second symptom is pain when pressing on the atlantooccipital membrane.

Kernig's symptom is considered one of the first manifestations of the pathological process. Its essence lies in the impossibility of independently straightening the lower limb if it is bent at an angle of 90º in the hip and knee joint. In babies, such a meningeal symptom may not appear at all. In infants up to 6-8 weeks and in children suffering from Parkinson's disease or myotonia, Kernig's symptom is the result of excessively high muscle tone.

Hardening of the occipital muscles

The muscle tissue located in the back of the head begins to harden with meningeal syndrome. This problem occurs due to an abnormal increase in their tone. The occipital muscles are responsible for the extension of the head, therefore, the patient, due to its rigidity, cannot calmly bend the head, since the upper half of the body arches along with this movement.

For people suffering from meningeal syndrome, a certain posture is characteristic, being in which the intensity of pain decreases:

Hands pressed to the chest;
Forward curved torso;
Retracted abdomen;
Head thrown back;
Lower limbs raised closer to the stomach.

Features of symptoms in children

In babies, meningeal manifestations are predominantly a consequence of meningitis. One of the main signs of the disease is the symptom of Lesage. If the baby is pressed into the armpits, then his legs reflexively rise to the stomach, and the head is slightly thrown back. An equally important manifestation is the symptom of Flatau. If the child tilts his head forward too quickly, his pupils will dilate.

The most characteristic sign for meningeal syndrome is a swollen fontanel (the area between the parietal and frontal bones). Other symptoms may be less pronounced or absent. Among the frequently occurring signs, convulsive seizures, vomiting, fever, weakening of the muscles of the limbs (paresis), capriciousness, irritability, etc. can be distinguished.

In newborns, meningitis occurs as follows:

Initially, the pathological process is manifested by symptoms characteristic of a cold and poisoning (fever, vomiting, etc.);
Gradually, the baby's appetite worsens. They become lethargic, moody and a little inhibited.

In the early days of the development of pathology, symptoms may be mild or completely absent. Over time, the child's condition will worsen and neurotoxicosis with its characteristic neurological symptoms will appear.

Meningeal symptoms depend on the cause of the disease, but basically they are virtually the same. In most cases, the symptoms are extremely intense, but people, not knowing about the possible pathological process, do not go to the doctor until the last. In such a situation, the consequences are often irreversible, and in the case of a child, he may die altogether. That is why it is extremely important to know how the disease manifests itself in order to start a course of treatment in a timely manner.

Meningitis is a particularly serious disease that provokes inflammation in the meninges. The disease can be secondary, resulting from infection of the body, and primary, in which a person becomes infected from a carrier of a meningitis infection. Meningitis appears in children due to infection of the body with viruses, fungi and bacteria.

Both an adult and a child can become infected with this disease, but the pathology is extremely dangerous for children. Therefore, parents should know the primary signs of meningitis in children, how exactly the disease manifests itself and how it is necessary to treat the pathology. Only with this important information, it is possible to provide qualified assistance to an infected baby in a timely manner.

Causes of meningitis in children

Absolutely everyone can get sick with meningitis - both a baby up to a year old and older kids at the age of 12-13 years. As a rule, the causes of pathology in children are the same as in adults.

Causes of viral meningitis include:

The causative agents of a bacterial disease, in turn, are:

pneumococci;
meningococci;
staphylococci;
bacteria that cause the development of syphilis;
streptococci.

But the causative agents of fungal meningitis are constantly the same substances - cryptococci.

Meningitis in children is serous and purulent: the first variety includes for the most part diseases caused by viruses, and the second - by bacteria. The simplest microbes, for example, toxoplasma or amoeba, are capable of provoking the disease, and this disease most often affects children under the age of four.

Depending on age children may present predominantly with a certain type of pathology.

Among other things, There are diseases that are catalysts for the development of meningitis:

Diseases of the oral cavity. From an early age, children whose parents do not carefully care for the baby's teeth develop caries. Surprisingly, but its too active development can lead to the formation of other pathologies.
Diseases of the nasopharynx and ears. As a rule, these are chronic pathologies affecting children aged 7–9 years. Of all the known diseases, sinusitis and otitis media deserve special attention. - Deformities of the nasal septum. Due to the incorrect structure of the skull in infants, the incorrect position of the nasal septum is quite often observed. As a result, these babies may develop meningitis after just a few years.

Successful parents should familiarize themselves with all types of manifestations of this dangerous disease, because no matter how old the child is, meningitis can leave him disabled for the rest of his life. Of course, it is possible to cure a baby, but for this you will have to stock up not only with knowledge, but also with a lot of medicines, folk medicines and time. In addition, it is unlikely that it will be possible to manage on your own in the event of a childhood illness - if the baby is still infected with meningitis, it is best to immediately seek qualified medical help.

The first signs of meningitis in children

Often, the first symptoms of meningitis in babies under 5 years of age are confused by new parents with a common cold. . The disease progresses rapidly and literally in the first days after infection, the child feels a strong deterioration in well-being. Signs of the disease in children of different ages are slightly different. But under the general symptoms in adults and children, doctors suggest a feeling of dry mouth and various manifestations of inflammatory processes in the body.

Symptoms of meningitis in infants under one year old

Confused mind is considered the main distinguishing feature of the course of pathology in very young children. However, in general, the disease almost does not manifest itself and for the most part resembles a common cold, rather than inflammation of the brain cells. Of course, the key problem in diagnosing a disease in a one-year-old baby is the inability to interview the child, because he is just naughty and crying.

If there is the slightest suspicion of an infection in the baby's body, parents should resort to examining the brain by neutronography and ultrasound. It is these procedures that will help to detect all kinds of viruses and pathologies in the child's body. At the same time, experts advise conducting neutronography in babies under two years old, because at an older age, the fontanel of the child will be completely covered with bone tissue.

Symptoms of meningitis in children under 10 years of age

So, in the first stage of the disease in children aged 2–3 years manifests itself quite clearly, accompanied by:

Even at such an early age, parents already have the opportunity to interview the baby and determine the listed symptoms. And it’s easy to talk with a child aged 5–7 years, finding out his feelings and the reasons for feeling unwell. In addition, at this age, children can often observe other signs of the development of pathology. For example, a child may experience discomfort when swallowing due to overdrying of the mucous membranes.

In fact, the symptoms of meningitis in children under 5 years of age are not much different from the manifestations of pathology at the age of 12 years. Symptoms common to these age groups include:

You can also detect manifestations of pathology in adolescents by focusing on this list, because the symptoms of meningitis in children 5–7 years old and older children are not very different.

Signs that make it possible to detect the disease in time

A few days after the onset of the first signs of the disease, there comes a period of a kind of calm. Usually, at this time, parents think that the baby simply suffered an ordinary cold and now everything is in order. However, the reality is quite different, and an insidious disease prepares a second phase for the child consisting of many unpleasant signs. During this period, probably:

pneumonia;
development of renal failure;
swelling of the brain;
numbness of muscle tissue;
coma.

Babies with meningitis Unfortunately, quite often they face such catastrophic consequences of pathology as psychological disorders, visual and auditory disorders, muscle paralysis, cognitive failures, and others. To avoid such results, it is necessary to resort to the only correct decision - a timely and competent course of treatment. To do this, the physician must distinguish the pathology according to certain signs:

In some cases, these symptoms are very weakly manifested, or they can be noticed at all only at elevated body temperature. In such situations, to diagnose meningitis, it is necessary to resort to instrumental methods of examination.

Diagnosis of pathology

In case of detection of symptoms characteristic of meningitis, the child should be immediately hospitalized. After all, this dangerous unpredictable disease is under no circumstances treated at home, regardless of whether it is found in an adult or an infant. Therapy should take place under the supervision of a physician, and The diagnosis of meningitis is made, as a rule, using the following methods:

Methods of infection

Meningitis infection enters the child's body most often due to a weakened immune system. There are such ways of transmission and infection of meningitis:

Fecal-oral. This method of infection should be feared by people who neglect the processing of products before consumption or who do not care about their own hygiene. The infection enters the body of a healthy child from the feces of a sick person or insect.
Airborne. This is the most common and dangerous type of transmission. One sick person can infect a whole group of healthy people. First of all, people with a weakened immune system, as well as those who are in contact with the carrier the most, succumb to the disease.
Transplacental. This route of transmission is dangerous only for pregnant women and their unborn babies. In the first trimester of pregnancy, when a woman is infected, the fetus dies. And in case of infection at a later date, the child acquires congenital meningitis.

Therapy

Treatment of meningitis infection in children, as well as in adults, should occur exclusively in the hospital. At an early stage of the disease, children are prescribed strict bed rest and a balanced diet. The menu for such a diet will be based on a large amount of protein and dairy products. And doctors eliminate the infection by introducing special solutions, for example, sodium bicarbonate or ringer.

If a child has been diagnosed with a bacterial variety of meningitis, antibiotics are used: for example, meronem or ceftriaxone. At the very beginning of therapy, these antibiotics are combined to fight several types of microorganisms at once. At the same time, experts prohibit taking medications containing glucocorticosteroids in parallel with antibiotics, since these substances interfere with the normal accumulation of drugs in the cerebrospinal substance. Fungal and viral types of meningitis are treated with antifungal and antiviral medicines, respectively.

Children should be treated when the first signs of pathology are detected. In case of timely detection and treatment of the disease, the infection will subside in just a few days. And the state of the spinal substance returns to normal after a couple of weeks. After this period, the child is sent for re-analysis. If the effect of therapy is absent within a week, additional studies are carried out earlier.

In the case of meningitis infection, symptoms and therapy should be interconnected, since during the elimination of the causes of the disease, it is necessary, first of all, to stop its signs. To achieve this goal, drugs designed to improve blood flow, sedatives and other medications may be needed.

Prevention of meningitis

Preventive measures for children:

Meningitis is rightfully considered one of the most dangerous diseases that can leave a child disabled. It is possible to avoid such a fate, however, for this, parents should be as attentive as possible to the health of their baby and familiarize themselves with all the known symptoms of meningitis.

Meningitis is a severe and life-threatening infection of the central nervous system in infants. The causes of meningitis in newborns are not much different from the development of the disease in children of other age groups. The main cause of meningitis in infants is the penetration of microorganisms into the child's body.

Inflammation of the membranes of the brain or spinal cord in children can be caused by various infectious agents:

meningococci;
hemophilic bacillus;
pneumococci;
group B streptococci;
staphylococci;
listeria;
klebsiella.

The most common cause of meningitis in infants is E. coli. The causative agents of infection in the Yusupov hospital are identified using modern laboratory methods. To determine the degree of brain damage, the presence of purulent foci in the brain, doctors perform magnetic resonance and computed tomography. For treatment, neurologists use the latest antimicrobial drugs that are highly effective and have minimal side effects.

A predisposing factor in the development of meningitis in newborns is perinatal lesions of the central nervous system. Meningitis can be an independent disease or a complication of another infectious disease. The primary focus of infection may be in carious teeth, ear, mastoid process, organ of vision. Only a timely diagnosis of meningitis and timely adequate treatment of the disease with modern antibacterial drugs can save the life of an infant and prevent serious complications.

Symptoms of meningitis in the baby

Signs of meningitis in newborns are usually non-specific. In babies, lethargy develops, periodically replaced by anxiety, appetite decreases, they refuse to breastfeed and spit up. Doctors determine the following signs of meningitis in infants:

pallor of the skin;
acrocyanosis (cyanotic shade of the tip of the nose, earlobes);
bloating;
signs of increased intracranial pressure (bulging or tense fontanel, "brain" cry, increased head circumference, vomiting).

Doctors identify such symptoms of meningitis in newborns as flinching, hyperesthesia, floating movements of the eyeballs, convulsions. At the first stages of the disease, you can notice a sign of Graefe, or a “symptom of the setting sun” - when the eyeball is lowered down, the eyelid of the baby remains raised, as a result of which the eye does not completely close.

Neck stiffness (pain or inability to bring the head to the chest) usually appears in the later stages of the disease. At the same time, neurologists find the following meningeal symptoms in infants with meningitis:

Babinsky reflex - with dashed irritation of the sole along the outer edge of the foot from the heel to the base of the big toe, involuntary dorsiflexion of the thumb and plantar flexion of other fingers occur (the reflex is physiological up to 2 years of life);
Kernig's symptom - the doctor fails to straighten the leg bent at the knee and hip joints at a right angle in the baby, who lies on his back (up to 4-6 months of age, the reflex is considered physiological);
Lasegue reflex - the inability to bend the baby's leg straightened at the hip joint by more than 60-70 degrees.

In newborns, for the diagnosis of meningitis, doctors use the Flatau syndrome (dilated pupils with a quick tilt of the head forward) and Lessage (pulling the baby's legs to the stomach in a suspended state) in combination with the clinical picture. Brudzinsky's reflexes up to 3-4 months of a child's life are also physiological. The upper symptom is passive flexion of the child's head with rapid flexion of the legs at the hip and knee joints. The average reflex is considered positive if, when pressing the edge of the palm on the area of \u200b\u200bthe pubic joint, the child has lower limbs. The lower symptom of Brudzinsky is positive, when, with passive flexion of one leg in the knee and hip joints, the other leg of the baby also flexes. Negative meningeal reflexes in infants are not grounds for excluding the diagnosis of meningitis in the presence of other symptoms of the disease.

The study of cerebrospinal fluid in meningitis in newborns

At the slightest suspicion of meningitis, newborns perform a lumbar puncture. The diagnosis can be confirmed or ruled out only on the basis of an examination of the cerebrospinal fluid. With purulent meningitis, cloudy or opalescent cerebrospinal fluid flows out under high pressure, a stream or frequent drops. In it, laboratory assistants find a large number of neutrophils. In addition to high neutrophilic cytosis, purulent meningitis is characterized by an increase in protein levels and a low concentration of glucose. To determine the type of pathogen, a bacterioscopic and bacteriological examination of the cerebrospinal fluid sediment is carried out. CSF analysis is repeated every 4-5 days until the newborn is fully recovered.

Tuberculous meningitis in newborns is extremely rare. Bacterioscopic examination of cerebrospinal fluid in tuberculous meningitis can give a negative result. For the tuberculous form of meningitis, a precipitation within 12-24 hours is typical in a taken sample of cerebrospinal fluid when it is standing. The sediment is a delicate fibrinous web-like mesh in the form of an overturned Christmas tree, sometimes coarse flakes. In 80% of cases, Mycobacterium tuberculosis is found in the precipitate.

Bacterioscopic examination of the cerebrospinal fluid in case of suspected meningococcal or pneumococcal nature of meningitis is a simple and accurate express diagnostic method. It gives a positive result at the first lumbar puncture 1.5 times more often than culture growth. Simultaneous bacterioscopic examination of cerebrospinal fluid and blood under a microscope gives 90% of positive results in meningococcal meningitis, if the examination of the newborn was carried out during the first day of hospitalization. By the third day of illness in infants, the percentage of positive results drops to 60.

With meningococcal meningitis, the disease proceeds in several stages:

first, the cerebrospinal fluid pressure rises;
then a small amount of neutrophils is found in the cerebrospinal fluid;
later, changes are noted that are characteristic of purulent meningitis.

Therefore, approximately in every fourth case, the cerebrospinal fluid, which is examined during the first hours of the disease, does not differ from the norm. In case of inadequate therapy, the cerebrospinal fluid becomes purulent, the concentration of neutrophils in it increases, and the protein level rises to 1-16 g / l. Its concentration in the cerebrospinal fluid reflects the severity of the disease. With adequate therapy, the number of neutrophils decreases, they are replaced by lymphocytes.

With serous meningitis of viral etiology, the cerebrospinal fluid is transparent, it contains a small amount of lymphocytes. In some cases, the initial stage of the disease is accompanied by an increase in the concentration of neutrophils, which indicates a severe course of the disease and has a less favorable prognosis. The protein content in serous meningitis does not go beyond the normal range or is moderately increased, up to 0.6-1.6 g/l. In some infants, the protein concentration is reduced due to increased production of cerebrospinal fluid.

Treatment of meningitis in newborns

Pediatricians, neurologists and infectious disease specialists make up individual treatment regimens for meningitis in newborns. The nature of the treatment depends on the type of meningitis (serous or purulent), the type of pathogen and the severity of the symptoms. Doctors individually select doses of drugs depending on the age and body weight of the newborn.

With viral meningitis, dehydration therapy with diuretics is carried out to reduce intracranial pressure. Prescribe anticonvulsants and antiallergic drugs that reduce the body's sensitivity to toxins and allergens. Antipyretic and analgesic drugs are used. Antiviral drugs and immunoglobulin are prescribed. In most cases, newborns recover in 1-2 weeks.

Bacterial meningitis is treated with antibiotics, to which various types of bacteria are sensitive. Since the analysis of cerebrospinal fluid taken during a puncture takes 3-4 days, empirical therapy with antibacterial drugs is started immediately after taking blood and cerebrospinal fluid for research. Express analysis results can be obtained within 2-3 hours. When identifying the causative agent of infection, antibiotics are prescribed, to which the identified microorganisms are most sensitive. If the condition of the infant does not improve 48 hours after the start of antimicrobial therapy, a second puncture is performed to clarify the diagnosis.

Meningitis in newborns caused by Haemophilus influenzae can be prevented by vaccination. The ACT-HIB vaccine, which is registered and approved for use in Russia, can be administered to babies from 2-3 months. Starting from the age of one and a half years, children are vaccinated against meningococcal infection with the domestic meningococcal A and A + C vaccine. The imported vaccine MENINGO A + C registered in the Russian Federation is administered to newborns if someone in the family has a meningococcal infection. Vaccination against pneumococcus with the PNEUMO 23 vaccine is done only at 2 years.

Meningitis in newborns is especially dangerous. Its consequences for infants can be unpredictable. Children after purulent meningitis suffered in infancy may lag behind in mental development. Toddlers develop deafness, visual impairment, and dysfunctional mental disorders.

At the first suspicion of the development of meningitis in infants, consult a doctor. Only the help of a qualified specialist will help save the life and health of a newborn.

Bibliography

ICD-10 (International Classification of Diseases)
Yusupov hospital
"Diagnostics". - Brief Medical Encyclopedia. - M.: Soviet Encyclopedia, 1989.
"Clinical evaluation of the results of laboratory studies" / / G. I. Nazarenko, A. A. Kishkun. Moscow, 2005
Clinical laboratory analytics. Fundamentals of clinical laboratory analysis V.V. Menshikov, 2002.

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